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05842 (BLCK)Building Address 54-600 JUAREZ Owner °�:�Q�tw 14 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 FUSTSt T &MRTCAN CONSTRUM0141 COMPANY Mailing Address F.O. BOX 1379 City Zil LA OUINTA Address P.Q. BOX 807 No. LDING: TYPE CONST. OCC: GRP Number 774-253-•005 x584 2 564-7411 Legal Description LOO 21) Project Description BLOCK 'WALL/RETA T1XG RAMS .501 X 2 8* 0 100' X 2:. State Lic. AMOUNT Plan Chk. Dep. & Classif. Plan Chk. Bal. I Arch., Engr., Designer Address Tel - �� 1:57 T4'Jl City Lic. # �1 Sq. Ft. Size City I Zip I State C. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under'provisions of,Chapter 9 (commencing with Section 7000) of Division 3 0 of BusjnEss and;ssiCode, and my license is in frill force and effect. 4,—f 1 ,1' �° Rrz-•—�. i s f 'X. If � 11 SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to (le a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a ami penalty of not more than live hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or inproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for safe. H, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason _ Date Owner No. Stoi No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 200.00 WORKERS' COMPENSATION DECLARATION . t hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. ( 38o071abo� Code.) Policy No Company 4✓"— ' L r'1 .� ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed g the pemut is for one hundred doilms ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation • ^ Laws of California- Date—owner alifornia Date owner NOTICE TO APPLJCANT. ft, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address " ' This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const.5.3i� Mech. Electrical Plumbing S.M.I. .03 Grading Driveway Enc. Infrastructure TOTAL REMARKS w,nwYx-. a, o "vim ZONE: BY: Minimum Setback Distances: Front Setback from. Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE IN PECTOR 612/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SQ. FT. ® $ UNITS SLAB GRADE 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CARP. SO. FT. ® TEMP. POLE WALL SQ. FT. ® GROUT DRINKING FOUNTAIN SO FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM VENTILATION KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. OND BEAM — WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL 71